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tv   Book TV  CSPAN  February 28, 2011 12:00am-1:15am EST

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whether or not obamacare is constitutional is going to be decided by this court. it looks like we have a california marriage decision on the way to this court. i'll tell you what's funny, in the confirmation, there's a marriage case out of california pending before the supreme court. so i guess life is em stating art, or vice versa, or a little bit of both. >> thank you very much for your time. >> thank you. >> we'd like to hear from you. tweet us your feedback at >> come up next, book tv presents "afterwords" an hour long program where we invite hosts to interview authors. susan jacoby in "never say die."
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90 is the new 50. she discusses growing older in america with aarp state news editor sylvia smith. age. what is the myth of the new old age? >> guest: the myth of an old age, we are all -- people that are not old. the aging boomers people in the 50s and early 60s and 40s. but our old is going to be lived in a way that's totally different from the way in which old age has been lived in the past. that we are going to all be sky
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diving -- yeah, that we are simply going to get older, but not actually old. >> host: so why do you think the cultures invested in sugar coating old age? >> well, it's very interesting. now when i was growing up, like all of the oldest boomers in the 1950s, i would say that attitudes toward old age were negative in a particular way. just old age was just something that started the minute a man retired. and he returned home to bother his wife. and her only role was to be the grandmother to her grandchildren, and that was the whole idea. not just of old age, but just of anybody who was retired in their 60s. now i think we've had a great corrective to that. which aarp has had a role in in the sense that we now understand that people over 65 can do a lot
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of things and that their only role isn't just lying around the house watching tv and looking after the grand kiddies. but there is a kind of new ageism, i think, that's taken over which is this. it's great to be old as long as you don't exhibit any of the typical problems of old age, and old age is also has been very much redefined in term of young old age. which sociologist and doctors call people in the 60s and 70s who are pretty healthy even if they've had cancer and heart disease and old, old age in the late '80s and 90s, so many bombers -- boomers are going to live. 90, well, i decided to write this book when i went to the panel at the world science festival, titled 90 is the new
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50. i thought does anybody really believe that? and the answer is that there are a lot of people in their 40s, 50s, and 60s who do believe that. so that we've -- it's the new kind of more subtle form of ageism in that it's great to be old, as long as you don't have any of the typical problems of people who are really old. >> host: you use the phrase old old. what do you mean by that? >> guest: well, old old is a phrase that's used by doctors and sociologist, it's used for people in the late 80s and 90s, as opposed to 60s and 70s. it's right to make that distinction. between people in the 90s in terms of health and abilities, i'm not talking about exceptions, i'm talking about the majority of people. to talk about them as though they were the same in their 60s is as absurd as 60s and 30s. there are people in their 60s that might like to think they
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are in 30s. they are diluted. >> host: you say the two overwhelming problems of old old age health that worsens, and the tendency for most people to get poorer. you suggest that there's collective action to take in response. what are the key points? >> guest: health there's not much we can do. there are lucky people who's health doesn't worsen. those of us who have parents and grandparents as i have know that the typical person has to deal with many more health problems over time. and this, by the way, the problems of the oldest old have to be looked at as not entirely, but they are huge's womens issue because right now the vast majority of people over 85 are women. and everybody gets poorer over time, except people like warren
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buffett, i'm sure he's going to be well fixed at 92. women in particular get poorer. because there are lots of thing that happen to total income with the death of a husband. this is true of women today, most of whom didn't work outside their home who are in the 90s. but it's also going to be true to some degree of boomer women, because women had more interpreted work patterns than men do. which reduces, the total amount of either pension or social security income over a lifetime. so people get poorer as they get older. and moreover, this is also connected with worse health. because people need many more services as they get older. that cost money. most of which none of our social service programs which the republicans are now so eager to cut and certain democrats as well pay for already. so that people's needs in terms of the assistance that they need if they'd like to go on living independent become greater at a
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time when their income becomes less. >> well, in fact, you mention in the book that you had a friend who when you told her you were writing a book about aging and old age, she said, oh, you are writing a book about women. women live longer. >> guest: right, and people in the age group, among women in their 90s, social security makes up about 90% of their income. there's not a lot of money left around by then. i would like to say something also that i often forget in interviews. i think that one of the problems here in thinking about this rationallally is -- rationally is which we do live in a society that people ought to be able to save enough to finance a 30-year retirement. but there's something wrong if you can't do that. this is ridiculous. when the social security act was
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signed in 1932, the average life expectancy was 62. people weren't able to save then. that's why social security was enacted. no one foresaw a time when all of the baby boomers who are turning 65, in 20 years they are going to be 85, they will be 8.5 billion of them. saving enough money to finance a ten-year retirement and 30-year retirement if you have an average income, if you are not rich, are two different things. it's not a matter of moral turpitude if the average family can't save enough. and furthermore, there's a really question of do we want a society in which a 45 or 50-year-old says i can't help you. i'm putting aside money for long-term care? is that a healthy society? i don't think so. >> host: some of the consequences, perhaps, of growing up as i did and you did in a age of medical miracles, i
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was just a little girl when the polio vaccine came along, there's always been antibiotics, and fake hips, fake knees, organ transplants, that's the medical norm now. how has has -- i mean people who have taken advantage or not been disadvantaged because they have had access to this kind of care -- would i think assume that that is a good thing? but you paint of sort of overall picture of your book that these things do have consequences. because they prolong life beyond what our social network, our social safety network was able to provide, or was created to provide. >> that's true. i think they have other consequences too. i mean antibiotics, yes, they do -- people who would have died of pneumonia at 65 if they got a bad case of pneumonia don't
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anymore. because there are antibiotics. talking about now in the older age group. i think there's something else about medical picture -- medical miracles that paints a picture. my first memory is standing in line for the vaccine too. i am just old enough to remember life in the summer before the salt vaccine in the early '50s when your parents wouldn't let you to go out swimming because they were terrified of polio. that was e -- eradicated overnight. because we have grown up in the miracles, we don't realize that some of the things that kill people in old age, alzheimer's disease, for example, or forms of cancer that hit an old age, or if they don't hit in old age, your immune systems becomes too weak to over come them. they are far more complicated, they will require if they are
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ever to be e meal rated, they require research at the basic biomedical level which is now going on, and they are very connected. the more alzheimer's research is being done, they assumed when they started it a disease that's common. and nearly half of all people over 85 have it. something else that nobody likes to hear. don't shoot the messenger. >> host: i have no gun. >> guest: right. these things are not as easy to find an answer to. not that anything like polio seemed easy before they found the vaccine either. but they are far more complex. most of the scientists i've talked to far from the '90s and the new 50s crowd feel the solution is even let's say something that would delay alzheimer's which would be a wonderful thing. they are much more likely to be there for our children and grandchildren. for people who are now in their
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50s and early 60s 0 count is really not being realistic. i like to quote my dear friend, dr. robert butler who died at 82 last year of leukemia. he was the first director at the national institute on aging, and he was the only voice of rationality on the 90s is the new 50s panel. i interviewed him for the new book. what do you think about the prospects say a cure for alzheimer's. honestly, i'm a scientist. nobody believes in science more than a scientist. i'd like nothing better than to wake up and see there's a cure for alzheimer's. he said realistically, i think the reason we need to invest more now is that it's still a long way away. furthermore, you can always hope for something like that, but you can't base a strategy for dealing with old age on the
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assumption that this is going to happen for you and magically whisk it away. i think that's my view. we can always hope for a medical miracle. but hope isn't a plan of action. hope is just hope. >> host: well, i felt that your chapter on alzheimer's was the most passionate in the book, or maybe i was bringing my own experiences to that. but talk to us a little bit about how you developed that chapter and the personal experiences that you had that maybe shaped that chapter. >> guest: well, alzheimer's is not in my family. my mother and my grandmother lived in -- my grandmother lived to be 99 with a ruined body and a sound mind. and i never personally had experience with alzheimer's until my partner who was 15 years older than i did got it.
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and mercifully, he died three years of cancer before the last memory -- last rem -- rem innocence of my mind left. although i know better, i've written about science. i know that intelligent, educated people get alzheimer's too. i had thought if you were smart and engaged with life and work hard and doing intellectual work and exercise and eat your vegetables, you are not going to get alzheimer's. this is nonsense as they found out in a major review. all of the people that believe that exercise and greens are going to protect them from alzheimer's, those are good things in themselves, the exercise, greens, intellectual work. they are not a magic pill that's
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going to make you not get alzheimer's. but one of the things about it that's so tragic, and when you think that the risk of it doubles in every five year period over 65. and that half of people who are over 85 have dementia of which alzheimer's is the leading cause. my partner, i remember when he was sort of the middle stages of it. when he could still do some things, but not others. i remember him turning to me and saying i feel it somewhere inside me is the person that i really am. the person that i was before. but he said i can't find him. i can't talk to him. if there's ever a definition of what happens in the dying brain of a person with alzheimer's, that is it. and you understand what this means and you also understand
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how tragic all of this false hope is. and why i have to say that one of the things that particularly enrages me are these ads for those so-called memory pills. i won't mention brand names, you know what they are. helping dad be more like himself. which by the way were also found to be basically -- have no affect at all in the national institute of health review. one daughter turns to the other and says helps dad be more like himself. what it doesn't show dad taking the pill, walking out of the house, getting lost, and not being found for seven hours. i'll close with more one thing. my partner took them. i know when he was still able to think things through, he had no faith. i can remember him taking the memory pill one day and saying in yetish, [inaudible]
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which means nothing will help. this is the punch line of a lot of jewish jokes he would tell in the days he could tell jokes. the false idea that there are all sorts of way right now to armour ourselves against this. this is not good for people. it's great to hope you'll never get it. not to think because you are living rights things are going to turn out right for up. >> do you think baby boomers are susceptible to that kind of wishful or illusionary thinking? which comes first, the products and the leaky pipes, the viagra, all those sorts of thing. >> guest: viagra works, it's different. it actually works. >> host: okay. the product that is are aimed at the baby boomers to make us think if we take them or use them, i won't change as i became
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80 or 85. >> i think there's a lot of -- i mean there's a lot in our history and social history that makes us have a lot of faith in the idea of self-transformation. you are the master of your faith, the captain of your soul, i don't for one minute want to denigrate the value of good health habits. things like exercise and so have been shown to make you healthier while you are healthy. they make you healthier in old age than they would have otherwise. they probably will. they are good things in themselves because they make your life better. they are not an anti-aging pill. they are something that is good for their own sake. but they are not any more than meditation or [inaudible] or all of them. we can all remember all of the self-help movements of the '70s. some of them were good, some of them weren't. but they don't armour you against something which is
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inevitable, which is getting older and the realities of disease and economic problems that now accompany getting older. there's some things that are not within our control. we can take the best of what life hands us, and part of that is the genetic hand that we are dealt. but i'd like to say that we are all capable of aging successfully until we aren't. >> host: what do you mean by that, aging successfully? >> guest: aging successfully, what i mean by it is making the best of your health at any given point. but what i think society means by it is not seeming old at all. now my mother is now 90. if you had asked me, she would have a prime example of successful aging four years ago. she did 25 hours of volunteer work in the critical care unit of her local hospital, a huge job. if anybody -- if you asked anybody about her, you'd know
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that she was on top of her game. she'd had -- like my grandmother. she has a fully functioning brain in a body that has let her down. it's now mostly confined to her room in an assisted living facility. so she was capable of aging successfully until some diseases she had had because as you get older, your immune system's ability to fight off things when you are 60 and 70 you can live with a lot more easily goes. and so what i mean by aging successfully is doing everything you can at that moment, but there comes a point unless there is this fairy tale that we all have it. i'm going to drop dead at the anal of -- age of 95 in the middle of making love while sky diving. with no pain, no disability, nothing leading up to it. who wouldn't want -- you don't get to choose the manner of your own death in that way.
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my mother who is very frank and has had living will and proxy for years, her children don't need to wonder what she wants done. my mother says frankly that she doesn't -- the life she's living now, she does not consider life. she would have liked to have drop dead of a heart attack while she was doing her volunteer work. that's not what happened for her. >> host: what does she think of your book? >> guest: she likes my book. by the way, it's interesting. i've had a huge number of e-mails in response to various articles that i wrote. the older the people are, the better they like my book. i've had a lot of responses from computer savvy people in their 80s say, you know, you've said what i'd like to say. but i don't dare say. and i find these things interesting. you asked about successful aging. what they mean by they don't dare say them, one of the ways in which you get viewed as a hip
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older person by younger people is this, you never campaign about your health. nobody in good health wants to hear. i don't think anybody in good health understands what it is to get up every morning and fight to deal with, you know, various pains and things like that that you don't feel the way a 30-year-old or 50-year-old does when you are 85, even a relatively healthy 85. so you don't talk about bad health. you in particular -- you don't talk about losses. you don't -- if you are grieving for a partner, a long-time partner who died, yes, you are allowed a month or two of tears. but i saw this ridiculous piece in the "new york times" a few days ago, a piece about some social scientist did a study that basically most people are supposed to get with it after about six months. yes, they may still grieve for their partner, but tears or
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thinking about the partner all the time or constant feeling of sadness maybe a sign of depression or something more. that is another thing. so you have to project a positive attitude. frankly, i don't understand anybody who six months after the death of a partner of 30 years feels okay and doesn't think about them all the time. but i think that is one of the positive thinking business is something that our society imposing on everybody. but with no group is more coerced by that than the old. because if you -- if you express sorrow or dissatisfaction when you are 85, something that in a 45-year-old would just be considered a normal gripe. at 85 it's oh, well, he's just a cranky old geezer. she's just a mean old crow. what people express when they are older is put down to old age, rather than the legitimate response to a loss which anybody
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would have if they had it in any age. expect old people have more of them. >> and i expect that old people are reluctant to express those genuine emotions because of a another point that you make in the book. the loneliness factor. when people get old, maybe their partners died. maybe they don't have the primary person to love or maybe there's not a child in the picture. and their social circle has shrink. i would think that what you are saying is that society coerced people not to be that crow or grumpy old man. it pushes people farther away. >> guest: it's true. that's affected the oldest old. one the reasons it's been advanced, women due better as widowers than men, is that women have more friends. this is true.
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women relate to other women more closely throughout their lives. at least now, that may not be true in the generation from now. but still, than men do. when a women lived to be really old into her 90s, then because she is the oldest of the old survivors, she begins to lose her female friends too. my grandmother, who did live to be 99, i talked to quite a lot about this. and one the things that she said to me was, and she was a person who always made younger friends throughout her life too, if anybody had an good of an old age until you can't, she did. she said one the hardest things about being in her 90s, she had outlived everyone who didn't see her as this old women, but when remembered her whom she was, a young and vibrant girl. they were gone. of course, you can have friends of all age, and good friends,
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there's a special thing to friends of your own generation. for people who live the longest, they have to cope with not just one loss, but a succession of losses as the people who aren't as hardy as they are die off before them. >> host: my father who is 86 lives in the area that he grew up. his high school class still has a reunion. it's just such a highlight of his year to go to this and see people he probably doesn't see from year to year. i think that element of having been children together and -- it remind themselves of themselves at that age. >> guest: right. even not necessarily children, but just somebody that you knew when you were an young adult. all of the people that, you know, that my grandmother and my grandfather used to do things, she outlived them all. and you -- even a loving child
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cannot make up for the absence of your contemporaries. >> host: you mention aarp a few times in your book. and say that the organization hasn't really helped american society have a full picture of the realities of the old, old. what should that organization do? i mean is it the big senior organization? >> guest: yes, i do believe that. and i should say, i'm not just criticized aarp, i wrote for aarp publications for years. who i'm criticized is myself. but my thinking about age has changed since i was writing for the bulletin and the magazine. i think that one of the things that aarp needs to do is it needs to first of all, stop concentrating which i think is does in it's publications, on the 50 and 60 and early 70 somethings and start presenting a full more -- a full picture of older people as well. if you look at any of the aarp features on people we love,
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almost all of them will be in the their 50s and 60s. i know that's where the business is. that's where the boomers are. and there will be one person in their 80s. and this was always the case in aarp publications because articles about people who are really sick and how they cope with it, i think they ought to be doing more of that. but they are also downer articles, it's hard to do them well. the story that i told on myselfs in this book, this was many years ago, none the editors there now were the editors then. i was asked to do a story about people who after a serious illness had made big changes in their health habits and had greatly improved their lives. and the first person that i thought of was a high school classmate. who had a form of cancer in her 50s that she was supposed to die from and she didn't. when it became clear she wasn't going to die, she responded by
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giving up smoking and losing 50 pounds, and they ran a picture of her. she was 56 then. i swear she was so gorgeous she looked not really -- anybody would have recognized her as the high school cheerleader that she was. i didn't interview anybody over 64 for that article. because i couldn't find these triumphant stories in people in the late 70s and 80s. now they exist. but i think simply by featuring younger people in these publications so constantly, and not older people, they are suggesting that people like in their 80s can expect the same results and defy aging in the same way that people in their 50s can. and by the way, i think it's fine -- people over 50, i've been a member of the aarp since i was over 50. but people in their 50s compare -- comparing them to people in their 80s is also ridiculous. but i think mostly the aarp
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publications present in their personal examples the sunny side of old age always. and i don't think that given the aarp represents all seniors and is going -- and has a huge battle on it's hands is and going to maintain medicare and social security in ways that old people need, that the aarp needs to start featuring more of the worst problems as well as the best case outcomes. :
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shows you how few of them there are because when anybody asks you about that, the only person that you can think of is betty white. [laughter] you know, the most wanted talk-show guest and so on, and i didn't player the by the way, this was about people who were old, really they were the gone to become young old. the series the golden girls i thought was completely unrealistic about life for women in their 50s and 60s. >> host: they had a lot of dates. >> guest: all the golden girls seemed concerned about is getting another man. i don't think it was in any way realistic about the problems of real women in their 50s and 60s faced. so no, i don't think that there is anything and popular culture because popular culture doesn't -- what it likes to look at is the rare old person like betty white who doesn't seem old. for getting, you know -- i couldn't move my hips and dance
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like betty white when i was 30. betty white is one of those unusual people, but i don't think there is anything in the popular culture that accurately reflects the lives of old people because it's a downer, and even not in popular culture the hbo production "alzheimer's project," which was the real first tv series to really examine alzheimer's and produced by maria shriver, of course, whose father recently died of it. there was a lot wrong with that series, and one of the things wrong with it was it presented only nice long-term care facilities or people -- it was horrifying enough it did accurately show what people in the last stages of alzheimer's are really like, but there was always a caretaker, a home, a woman. there was nothing in that about the people who have no caretakers in the late stages of alzheimer's.
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people who are not in a nice nursing home whose life savings have run out and are in nursing homes on medicaid, and i've done articles on nursing homes when i was younger and they are not nice places and so that they did not -- in a way it showed the worst case individual scenario, you lose your mind. but there was always a caretaker, there was always a woman, there was a woman who had given up her job in minneapolis to care for her mother. who's going to care for that woman of the years that she has lost caretaking? that is a very, very serious issue, which is -- >> host: you mean because of her earning power. >> guest: yes. let's just say a woman is willing to quit her job in her 50s to take care of her mother, well, that woman is going to need to be taken care of in one way or another when she's older, and the fact she quit her job, we don't have anything really that provides for long-term care in homes even for people in the middle stages of alzheimer's.
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when my partner was in the middle stages of alzheimer's -- and i emphasize he did not reach -- cancer mercifully took him before that -- but there were a lot of people involved in his care, and he had something i thought was stupid and devoted children, and people who subbed for each other. he had a big network, and for when there couldn't be somebody there because he did reach a point he could really not be left unsupervised, even though he could still do things like enjoy old movies and things like that. but he couldn't be trusted not to turn the stove on and burn the house down. he had taken -- when he retired he took a lot of medical benefits that provided for home care. we needed that. most people can't afford that. and we are now talking about cutting down, when in truth to provide home benefits for families who are willing and able and eager to help care for a person costs so much less than
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to let people's life savings run out and put them in a nursing home. >> host: you make a number of criticisms of the medicare program, particularly that assistance for the home caregiver isn't covered. why don't you talk a little bit more about that. >> guest: and this is a hard thing to talk about, because nobody is talking about expanding services now. all people are talking about in medicare is the ways to cut them, and in fact i think there's a number of things we are going to have to do to reduce end of life care which only prolongs death, and i will talk about that in a bit. but it is a great criticism of medicare that you cannot -- let's say you have a husband at home in the middle stages of alzheimer's, the you cannot care for him 24 hours a day. you have the job yourself, and income you very much need. medicare will not pay for people to come in for eight hours a day, eight hours you need to work, which would be so much
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cheaper in the long run, but we are a country that doesn't do long run thinking, than having people lose their assets and having to put somebody into a nursing home, when there's someone who is willing and eager to provide care at home if only they have some help. >> host: the statistics i've seen is that nursing homes cost maybe three times as much as assisted home care. >> guest: that's right, and there are people who need nursing homes, -- stay at home longer. there are healthy old people who could live independently launder if they could have nursing homes -- if they could have some kind of home care, not necessarily medicare, which our society doesn't pay for unless you have completely exhausted all of your assets. this is going to be an urgent issue as more boomers look to be over 85. and of course now there certainly isn't going to be any discussion of it right now,
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because all we are talking about is about how to cut the cost of medicare. well, now i will talk about that. i can tell you -- i can tell you one thing, one thing that would cut the cost of end of life care and it's not death panels. it is the thing that out of political congress has been retreated from, which is paying for voluntary consultations between older people when they are healthy -- it doesn't have to be when they are sick, in fact it's much better if it isn't -- talking with their doctors about what are their feelings about end of life care, would they like, for instance, do they want -- there are two things that do everything which means as long as the heart is beating whether you are in a coma or not, and that is what we spend a huge proportion of the medicare budget on in the last month of life. i think if people were encouraged to discuss this with their doctors, and by the way, doctors are just as scared of death and dying as everybody
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else need this discussion as much as the patient would encourage them to go home, talk to the people they love, investigate the legal issues. only one-third of americans have living wills. even fewer have what you also need which is someone legally appointed to make decisions for you if you can't take care of yourself. if only half of the 70% of americans who don't have any end of life care instructions would make those decisions for themselves it is incalculable how much, since we spend so much in the last month of care. and this is not deaf panels, its people being encouraged to think about what the 90% of americans say they would like to die at home. only 20% do. malae will definitely use my mother as an example. she made out her living will and appointed my brother and me as her legal representatives 30 years ago and we are in no doubt about what she wants. and in fact, she has rejected all kinds of care already.
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we don't have to make decisions for her now because she is of sound mind. if she ever is not, then we will do exactly what she said, we would be afraid not to. but the point as she is taken care of. my mother is not come to cost one-third of the medicare budget in the last year of her life. she understands and accepts the difference between care that can only prolong her doherty and can return her to a good quality-of-life and there isn't much of that for her any more, and she made these decisions when she was healthy. and i'm not saying every that he is as strong minded as my mother. but a lot of people are if they are encouraged to do it. that is a way, without having death panels or even talking about assisted suicide we can encourage people who want to make plans for their own end of life care to do it instead of avoiding the subject and the feeding it. >> host: so if somebody wants to have a living well, tell us what that means, what steps
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somebody has to go through, but questions have to ask themselves and answered. >> guest: first of all the living will, not every state by the we recognize is living wills. first you have to find out what your state law is of about this. this is something -- aarp is full of information. if you can't use the internet you can call the appropriate office at aarp, and they will tell you exactly what your state law is about this, and even those people who can't use the internet, which i think more boomers will be able to use the internet but even if you can't, you can call up aarp, you can call your local citizen's council yet they will tell you what the state of law is. it is a myth if you are not rich, if there are financial issues involved with your regular well, you need to have a lawyer for that. i understand there are people who want to do the do-it-yourself "after words" but there are all kind of senior centers that offer aid with that of a fairly moderate rate.
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but for a living well, a living will sort of state your wishes, you know, seeing a living will states for a civil in new york state that if there is no chance of am i returning to life, being able to speak to again i do not want to be hooked up to ventilators, i do not want to be force fed by tubes. it spells it out quite explicitly. and any -- any lawyer will draw up one of those and stage that. but a living will is not all you need. you must discuss this with whoever and point a legal representative to act for you if you cannot act for yourself because many people by the time these issues arise can't act for themselves. your children, your spouse or your friend if you are not married. this is going to be bigger issues for boomers because many boomers are divorced, boomers have smaller families, the assumption that there is when to
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be someone, and by the way, the person you appoint me not necessarily your child. it will be if you don't appoint anyone coming and it may be a child who doesn't agree with your ideas about that at all. people need to appoint legally a representative, and you actually do need a lawyer and a notary to do that, but it does not cost a great deal in most places. if you call aarp or a senior organization they will tell you how to find legal help with this for not very much money. but you have to have the will that spells out what you don't want done to give you can't recover, and somebody to sign the papers for you if you cannot assign them for yourself. >> host: >> guest: the people who criticize this and talk about these as death penalties -- panels, as far as i'm concerned, they are idiots. leon kass, who was not an idiot, he is a famous ethicist, and he was the chairman of president bush's counseling bioethics,
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president bush the younger. he is opposed to living wills because he writes that no one can possibly imagine what they would do in all future contingencies, and there's no substitute for a loving partner. well, good for him. he's got a loving partner, a wife. but there are a lot of people, particularly women, who won't have a loving partner even if the had a loving partner for most of their lives and while it is true you cannot know what you would do in every circumstance, i can't know, you know, whether if my knee gets worse i'm willing to go through a knee replacement or hobble around on the knee that a tour of a lettuce leaf 20 years ago. i don't know the answer to that. but i do know that if the brain, my high your brain functioning sardonic, that i do not want to be force fed to keep my body alive, that i do not want to be hooked up to an artificial
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ventilator if i'm 85-years-old and cannot breathe on my own. but i cannot answer what i would do in every situation doesn't mean that i can't know what i would do in the most common situations. and i feed whatever anyone says about this, i do think the objections to this are a particular kind of highly conservative religion. religion -- i was raised a catholic, i'm an atheist but i was raised catholic, and i know the catholic church has no objection to seeing you don't want, you know, to be on even a leader if you can't get better. that is not -- that is not considered suicide. it's considered you don't have an obligation to have everything to keep your body alive as long as possible. but there is a particular kind of i would say very antiindividualistic religion, which says that everything is in god's hands. we don't have the right to make any decisions for ourselves. and i think that is where the opposition on the far right is
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coming to the whole idea of living wills. because mainstream religions do not object to these things at all. many mainstream religions to object to assisted suicide, but that is a different thing. assisted suicide is a very different thing from saying i don't want extreme things done, just to keep my heart artificially pumping when i'm never going to be me again. >> host: well, you do say that suicide or assisted suicide can be a rational choice. and you go on to make the point that in medicine at least have it practiced in this country tends to view anybody who reaches that decision that that's the option that they want to take has either lost their marbles or is depressed and can be cured by hills. >> guest: welcome the fact that -- the fact that suicide is rare under any circumstances is borne out by states like oregon that have had assisted suicide calls for ten years. very few people use them. the number of people who have
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used them are people who are terminal within six months and who number in the hundreds. many who went through the process of applying for this didn't do it. most people are not going to commit suicide under any circumstances. but i believe that for people who are in unbearable pain, it is a rational choice, and i don't agree at all that everybody who wants to commit suicide is irrational or depressed and i think this is part of patronizing i don't deny for a minute that there are some people who are depressed for example i will give you an example of people who are depressed, there are people who in the 60's and 70's or even when they receive a diagnosis of something like say multiple sclerosis or parkinson's which you're eventually going to die out but unlike say alzheimer's or very old forms of cancer they're manageable and treatable and you can have a meaningful
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life for a long time. they are not a death sentence, but there are people who will treat that kind of a diagnosis as if it were an immediate death sentence. those are people whose thinking is distorted, and many of them might need not only to be on anti-depressant but to have therapy and to have their disease explained to them better so that they don't. a lot of people who treat something that isn't a death sentence as a death sentence are depressed and irrational in their thinking about what is always at low. who likes to be told they have ms or parkinson's? nobody. but as we can cite huge numbers of examples of people who live meaningful lives long coming years, decades after the diagnosis, you can live with it on like some of the worst diseases of old age. but to say that everybody, even people who are not terminal, that everybody who says i have had a good life and i have had enough is depressed. one example i used my book is a 100 to your old man in
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st. louis, very well known in st. louis. i'm sure the shrinks would have loved to have gotten their hands on him. he was a leader in the jewish community. he built half of st. louis. in the 1940's when st. louis was still very much a southern town and its racial attitudes, he insisted that unions on his construction projects and make african-americans. he was a huge civic figure philanthropist and builder and st. louis, and he was just fine until he was about 99 when he fell and broke his hip. anyway, again, a great example of someone who could age successfully until you can't. then he had to have a companion which for a man like this he hated. there was nothing wrong with his mind. two weeks before he committed suicide he had given a long from memory speech at his synagogue about his life, about what a great life he had had. he ought to wives, some children come he has grandchildren. what he did one morning, and he could living with a companion.
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well, sure there are a lot of people who commit suicide are all crazy, thank god the health professions didn't get their hands on him. she, one morning, stole the keys to his companion's car. he had been a champion swimmer in high school and college. he drove it from his lifelong -- i mean he had all the money in the world. he would have died at home, but he didn't want his every move monitored by another person, obviously. he drove his car to the missouri river, got up on the bridge and drove off it and committed suicide. now i am not advocating that people do this. i'm saying i don't think this man was crazy. in the letters he left for his grandchildren said please don't grieve for me or think i was out of my mind. he said i don't want to live until i have no control over my own death. i can't do any of the things really that have given my life meaning, and i think this is the case of a man that city enough, i have had a great life.
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it's downhill from here. and again, i don't advocate this. but i don't think he was crazy, and i am glad that some psychiatrist with anti-depressant and xanax didn't get their hands on him before he took his own. >> host: don't want to get away from this before i ask you with the two or three or four public policy decisions or retrofits need to be done in order to start addressing the issues that you raising your book. >> guest: you mean everything that's being talked against in washington right now. one, we need social security and to his hawk in desperate straits right now but we need not to reduce social security benefits. >> host: not increase the retirement age. >> guest: no, actually i think we can increase the retirement age. i think we can increase it a few years. but it has to be with an understanding that it's not an
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absolute requirement. i hate the idea of retirement. until the public fires me i'm not retiring, which could happen. [laughter] but until then, as long as i have my mind i intend to be working. but there are people who have spent a whole lifetime of physical labor, and i don't just mean working in coal mines. i also mean i consider physically on the body. having stood behind the retail counter on my feet for 40 years is far more physically taxing the and having been a writer. there are people who need to retire before age 70. firefighters, but not just that, there are a lot of low-income jobs that are relentless physical work, and i think that to say, for instance, that everyone who is made their living, say as a health care aide in the hospital can't retire until they are 70 is wrong. so i think that there have to be a lot of exceptions. raise the retirement age, yes,
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but also build a lot of physical the exceptions, you know, into that law. the hardest thing in the world to do. we do have to raise the retirement age. for a lot of people, the retirement age could be raised to 70. for a lot of people, it can't. there is no one-size-fits-all. i don't think we need to cut social security benefits at all. i think we must not because they are not that generous now. three-quarters of people over 75 live on 34 fell $7 a year or less including social security. does that sound like rich and greedy geezers to you? but first of all, we need to raise social security withholding tax and apply it to everyone. >> host: even the rich people? >> guest: absolutely -- no, but even people -- right now i think the ceiling is $109,000, and there aren't too many people who make more than $109,000, but everybody should pay social security withholding on every
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bit of that they make, whether they make -- with a $109,000 or $1 million. that said, lynn you can do that. there will still probably have to be an increase in the tax as well. cutting the retirement age and taxing all income will do part of it, but there will have to be probably a higher tax. i don't think that high taxes, and i am not in that fortunate millionaire category, higher taxes i understand our dirty word and what we have not as politicians who are encouraging the public and the reality about this. polls show the majority of people are totally opposed to cutting either medicare or social security benefits. they're also totally opposed to paying more taxes for it. that cannot be. right now we have no politicians in either party who have the courage to tell people we cannot cut social security benefits.
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old people need that. i think also, yes, you could also have a means test and people who make $1 million a year or 80-years-old don't need social security. but that is such a small percentage of it that inevitably reforming social security is going to mean raising the retirement age in a sensible way, taxing a pretty on all of their income for social security and probably raising it. if we don't do that. if we don't do that we are going to undo the most stellar achievements of the american 20th century which is the reduction of old age poverty. medicare is harder. the medicare system and again, i'm talking policy in the sky because nobody is talking right. every morning on morning show i hear them talk constantly about the need to cut entitlements. medicare, medicaid.
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medicare does need a fix, but it's the kind of fix the has to come the way that it's come on that. the equivalent of old age medical care doesn't cost european countries the proportion of the gross national product as it does us. why? first of all, there are real tight government ceilings on certain procedures, and if you have government cost controls, for instance, for the bush prescription drug plan which passed the prescription drug plan, a great thing, but without passing the cost controls and which the government demands certain concessions for the big farm which can still make money, you know, charging a lot less for those drugs. if the gun is going to be your biggest customer, it has the right to demand a ceiling on drugs, which cost the same drugs, which cost so much less in every other country in the developed world. there is no solution to providing universal health care for the old without more government cost controls, but i
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believe also there really is no solution to the problems of medicare for the old, the financial ones without a solution to the rising cost of health care and health insurance for the young. i write in my book when i started working at "the washington post" in 1965 social security seemed a lot bigger on a 105-dollar a week salary than a bit later but i did resent it. that was for my grandparents. however, if i had a good health insurance from the "washington post" -- and health care didn't cost that much then -- now, for the last 20 years i have been spending 15% of my after-tax income for a that private health insurance plan. the next generation below the boomers, of whom there are fewer than us, is not going to so easily accept those taxes for medicare and social security if the cost of their own bad health
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insurance keeps rising. i don't believe the one problem can be solved without the other. and by the way, i am not very impressed by the stands of old people over 65 on the last health care bill, which whatever you think of the bill was a first attempt to address this issue. the majority of people over 65 were opposed to universal health care for anybody but themselves. sorry. bad thing. the aarp knows that. a lot of people resigned because the aarp supported that health care bill. there is no solution for the young are not going to support the old if the old dolph recognize the financial stresses of the young as well. >> host: one reviewer called it your book or called you a reality instructor and says it isn't a cheerful. [laughter] are people buying it? >> guest: i don't know actually. on an input to our land in which you hardly know, but i will tell
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you people either love or hate this book. the people that hate it, heat it because they say it's too pessimistic. i call it realistic. the older people the better they like it. the floods of e-mail but on an offer website for people in the 70's and 80's this is a wanted to say but didn't feel i could say. people either love this book and considered it saying something that they've wanted to say or they considered it an absolute diatribe. >> host: you said your friends and fellow writers encouraged you to and the book on a happy note. >> guest: i tried. [laughter] >> host: did you? do you think it comes of happy? >> guest: no, i tried to -- well, they wanted me to end the note on what good advice to i have for people to solve these problems. >> host: solve the problems of old age. [laughter] >> guest: one of the things i see in the book is old age itself is not ultimately definable. the practical pieces of advice i
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have, they would work for everyone, first of all the think people need to stop thinking about retirement unless the whole purpose in life is living in a sunny climate, which i edmund after this winter seems more attractive. but the best place to be older in cities with public transportation systems. there aren't a lot of them, but there are some. >> host: you've got fallin tonnes in new york and here, don't you. >> guest: one of the things that is so bad about a lot of this country is the minute you can no longer drive you can no longer have a life. people can be an excellent entel shape, wanting to go to the theater, wanting to go out, wanting to go shopping, wanting to do all of these things they are perfectly capable of doing but not for let's say reasons of vision or something like that, unable to drive safely. well, in new york i see it everyday. i see people pushing their walker on to the left of the buses and giving all kinds of places. i see people with a little more
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money getting taxis, but you do not need a car to live in only a few cities of this country. so we have a country without public transportation. it is actually a trend, people moving back to the cities when they reach retirement age. i do think that with your it is paid or unpaid work, people who have their mind need to keep engaged in working in the community as long as they can. not because it is going to guarantee they will never get alzheimer's or die and they can defy old age forever, but because it makes for a meaningful life now. but apart from that, i don't know in other words those are things that are controllable. you don't live the life of a vegetable when you're not want to read you live in active engaged life and make the best of your physical situation. new york is an assisted living community. i don't understand why more places like lansing michigan where my mother lives don't deliver food at home for people and they don't.
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there are cities that have a culture of delivery and people who don't. for old people on days when whatever you've got is acting up, you know, being able to get your drugs delivered come in new york it's part of the cost of doing business, they don't charge extra. being able if you don't like the food that you have in your refrigerator or that you're assisted living community is serving being able to order some chinese, this is a great thing. new york is an assisted living community in ways a lot of cities aren't. i think carefully about retiring to one of those retirement communities where even though they have services, if you don't have a car, you just can't get around. i was talking to a bunch of people in florida about that, and they said the car thing, they were people who were young, but they say they were very worried about the driving issue. and i think it's too late. we've had social policies, which encourage this kind of dispersal so that a lot of people are stuck, but i think very
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carefully if i were a younger boomer in my late forties about wanting to retire to the sun city. i did and my book with my grandmother who just -- one of the worst things, there are practical reforms of long-term care facilities, too. they should segregate people with dementia from people without. one of the worst things about the last years of my grandmother's life as she was one of the very few people in the place where she was who didn't have dementia. she couldn't sit out to dinner with someone and have a normal conversation with them. that is a terrible thing. i remember the last time i saw her she said to me, took her to a river bank nearby, and she was so happy she said it's good to be among the living. but the last thing she said and the last time i saw her she looked out at the water and she said it's good to know that the duty of the world will go on without me. >> host: and that is a lovely thought which we will end. susan jacoby, thanks so much. the book is "never say die." >> guest: thank you.
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the problem of monopoly over the long term is that will live starts promising and results in the golden -- often results in the golden age, over the long term, entrenchment leads to the paranoiacs, said nancy and abuse over the long term. cbs and nbc when they started had a lot to say for them by the 1970's things had gone too far. and so what i guess i suggest in my book, a more modified version of the position is important to have the institute, the sort of structure to support quality
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things, but not the the cost of entrenching the monopolist for so long that they just lose any sight of what they have to do. and i think that is what happened with the media organizations in this country by air around the 60's and 70's. >> to more questions. one is a sort of prescriptive and one is descriptive. i will do the descriptive one first. you do a wonderful job of the book in describing the tragic process you just described briefly where a new communications medium comes along. all things are possible and there are these wonderful dreams of how fabulous it is going to be and this -- the title comes from the now long forgotten period where there were such dreams about cable television you may remember those days and then inevitably the bad guys take over and get their hand on the master switch. how can that not happen again if it happens every time? >> journalists need to
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understand the importance of creative destruction in the journalism industry. we have to have a dynamic industry. we want to see companies donley and be destroyed. journalists are sort of afraid of death. [laughter] a poor relationship with -- >> that's so on a fair. [laughter] >> journalists and media people -- dhaka these brands. the new york time has been going -- that is unheard of in other industries to have any sort of turmoil or natural market process to have brands that last for hundreds and hundreds of years and have these dominant positions. the journalists are exactly -- what is needed in journalism is a dinosaur, a little bit of creative destruction of goods not comfortable journalists will be upset in the long run it will be good for you. [laughter] >> you're switching from descriptive to prescriptive. let's switch back to descriptive for a minute. the model i think richard with see this based on my reading of
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his book is tim, you're dreaming because, you know, any communications medium as powerful as the internet just cannot -- you know, the liberal reformer public-interest advocates just cannot ever build a big enough fence around it to keep the process that's always happened in the past from happening again. so just as a practical matter, how do you think we can prevent this process that you have convinced us is a cyclical from happening in this instance? >> sure. this is -- the answer is related to my other work on things like matt neutrality, which is to say they're always needs to be channels whether it's the internet or other channels where the new can challenge the old, where "the new york times" gets a run for its money and nbc is sort of facing off against youtube videos. there has to be these channels, and the problem with -- i will
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go on the offensive and say the problem of the capitalism in your book is that it's too insensitive to the fact that the manager real capitalism tends to make more to market entry very difficult to put it that way. >> the problem with your argument, tim -- [laughter] is that there is no getting around the end of the devotee of the cycle. if i read your book, i would come away very depressed because every single case you tell is one in which you have these old innovators with these great ideas who were stomped down upon by these sort of either money mad or reactionary plutocrats and then something happens and this wonderful idea is born and someone's garage or someone's attic and starts up again and that just isn't so. there were major public policy
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triumphs. bell loses big time in the 19 teams. they don't get to control of telegraph as well as the telephone. the kind of separation principle you write about so persuasively and moving in your final section. radioactive 1927 keeps at&t alphacontact business. contant, a conduit or divided. if you had not had the studio system in hollywood where you have the coming together of the people making the movies and the ownership of the feeders the united states might never have established a dominant position in the poor old film business as they did in the 1930's and 40's. we have 80% of the world market. the europeans couldn't get their act together. we did and then made it possible the creativity that led to the self sustained development of hollywood. >> if you didn't have a hollywood studio system you also wouldn't have had the example of the private censorship in american history.
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privet censorship -- >> that is a ridiculous claim, tim. [laughter] the most heinous example of censorship -- >> private censorship. >> tell your story and i will tell you why you're wrong. [laughter] >> thanks to the consultation and the integrated studios, every -- the catholic church was finally able to enforce the production code and set up a system in which you're familiar with and the audience in which one man, joseph breen had to okay every single film before it was made which sculley prior restraint and would be so a legal if it was a government system, but we have a system, and what me give you one example. border brothers wanted to make a movie, wanted to make a movie about the nazis were doing in germany. they were like listen, this is bad. you know, bad things are coming. joseph corrine who described his
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job as shopping efiks down the throats of the jews, that is how i described the job. here to shove efiks down the throats of the jews. the movie was never made, and i don't know if it would have prepared anything but this is censorship that should be intolerable to anyone in the journalism school. for one man to decide what american film is. >> this is the problem with the whole book. the zero would individuals who rise out of nowhere, the mobil makes the market medium. look, the reason that joseph greene did what he did is because seven states were poised to enact codes of their own and those states that could have created a patchwork of restrictions on movies to goodness knows what consequences would have been. the studios worked with joseph green because it was all the alternative to the government censorship at the state government level and that would have been reminiscent of the censorship that the state level over all sorts of matters that persisted right up until the new york times. >> visit to watch any of the programs you see here online. type the author are book title
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in the search bar in the upper left side of the page and click search. you can also share anything you see on easily by clicking share on the upper left side of the page and selecting the format. book tv streams live 48 hours every weekend with top nonfiction books and authors. we are here talking about the new book. can you tell us what it's about? >> it's a rubout the rise of radical islam throughout the world. we are witnessing right now and islamist movement driven by the radical minority in the islamic religion that's trying to cause problems around the world through terrorism and bringing back their islamic caliphate. so that's what the book talks about. it talks about the history of radical islam, how what it's doing in your pride now, the islam in europe and what is happening in the united states as well and why we need to be mobilized to understand with fred of radical islam is coming from and what we can do to protect our society. >> and what are some of the
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findings >> we are finding that the radical islamic terrorist cells are very well organized weather in europe were in the united states or in australia. they are not working together. they are linked together through the internet. we are finding out that al qaeda, which means the base in arabic, is nothing more than a comparable organization with many of their radical islamist organizations that come underneath it that share similar goals. lately we have been hearing a lot about the muslim brotherhood, but considering what's happening in egypt, the muslim brotherhood is the mother ship basically that launched of these terrorist activities. the muslim brotherhood was founded in 1928 and has 70 islamist organizations including al qaeda and hamas. so the chapter in the book is dedicated to the muslim brotherhood project, and in particular to the muslim brotherhood project for north america. spec tell a little about your background. how did you become an expert in that terrorism really? >> i was born and a priest in lebanon, and my 9/11 happened to
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me personally in 1975 when the radical islamist blow up my home bringing it down bringing me under the rubble. i ended up in a hospital for two and a half months and leader ended up living in a bomb shelter underground for seven years of my life hiding to survive. i became very concerned about national security. even as a child. i grew up and i went to israel and can use worker as a journalist. i wanted to understand what's happening in the world. and what contributes to certain things around the world, certain movements, worked as a news anchor for zero world news from 1984 until 1989, and as i reported on the defense back in the 80's, i started connecting the dots and realizing that the name of the perpetrators were always the same. the names were always the same. mohammed, hussain, the name of the victims were always westerners, christians and jews, terry anderson, colonel, the
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twa, but the flights, and i can go on and on, and i started connecting dots and realized what i thought was a regional problem between a majority of muslim middle east trying to kill or expel the minority christians and jews had become a worldwide problem. the world was not connecting the dots. and when i came to the united states, i thought i left everything behind me. i mean, i'm an american now, all of the radicalism is left behind. it september 11th changed everything for almost all of us in the united states and the world. the way we travel, the way we live, you cannot turn on the television without hearing about some radical activity happening around the world, and so that is what drives me to do what i do. >> and quickly can you tell me what your next project is? >> i am working on another book and it is going to be discussing the grassroots movements around the world, not only in the united states, but help the internet gives power to the people to rise up and mobilize and get involved in their own
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government. we are witnessing a revolution around the world right now, and the internet is an powering that. i can tell you my organization started out of my bedroom on the internet we were nothing but a website. today we are the largest national security grassroots movement in the united states. 160,000 members, 510 chapters nationwide with a full-time lobbyist on capitol


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